Clinical informaticist says the best is yet to come for FHIR

By Jessica Davis
05:19 PM
InterSystems' Russell Leftwich, MD, says 'there's still a lot of data yet to be incorporated' with the HL7 standard.

The FHIR interoperability spec brings healthcare forward, helping it catch up with the technology other industries have been using for the past decade or two. It's healthcare's version of what other industries or domains have used for some time now. And what healthcare is most excited about, is the "ease of interoperability."

This is according to Russell Leftwich, MD, adjunct professor of biomedical informatics at Vanderbilt University and senior clinical advisor for interoperability at Cambridge, Massachusetts-based InterSystems.

Leftwich also founded and is co-chair of the HL7 Learning Health Systems Workgroup and is former co-chair of the HL7 Patient Care Workgroup. 

[Also: Innovation Pulse: Hardest part for FHIR lies ahead]

"FHIR data is self-explanatory, you might say," Leftwich said. By its nature, as it's an online standard, it doesn't require a team to build an extensive interface, which can take months to create, he said. Instead, IT teams learn how to use the standard in a matter of days, as they're already web-savvy.

Not only that, but FHIR can easily translate between standards. Those IT teams already familiar with standards will find FHIR is simple to use, once the data is inputted.

In the past, interoperability referred to both the sender and receiver of data using the same kind of system. But according to Leftwich, "We've reached a point with the explosion of knowledge and data that we need something more. We need the ability to translate between standards, so there's interoperability in that different systems can understand each other.

"Existing HL7 standards aren't really changing because of FHIR," he explained. "They're evolving, as they always because new technology has come along with new workflows, technology and domains.

"Standards have to be built or expanded to include the new types of data," he added. "FHIR is built on the latest technology to be able to handle the new types of data, but it still takes advantage of existing data and capabilities."

And while FHIR is in its early adoption stages, the industry has seen the best use of the standard in the mobile devices and apps, Leftwich said. FHIR is the type of technology built for these apps, as the standard uses the same type of code as apps. 

[Also: How FHIR is setting the stage for population health]

"FHIR is much more adoptable for enabling those types of devices and the IoT," he said. "Whereas, the older standards, just didn't work for mobile or apps."

But the biggest challenge to making the best use of FHIR is the agreement on how to represent the different pieces of data, said Leftwich, who said that, while he believes progress is being made, "there's still a lot of data yet to be incorporated into the FHIR standard.

"The easiest and most fundamental elements are already done and in use," he added. "But there's quite a bit more to be done. It just takes time and work from the community building out FHIR, for the to go through and agree upon how to represent the data concept."

Twitter: @JessieFDavis
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